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• The Bi 2 O 3 /BiO 1.3 I 0.4 /persulfate system could effectively degrade propranolol. • The system maintained high degradation ability under neutral and alkaline conditions. • NO 3 − had almost no effect on the degradation of propranolol. • 1O 2 and h+ played important role in propranolol degradation. Non-radical activation of persulfate (PS) by photocatalysts is an effective approach for removing organic pollutants from aqueous environments. In this study, a novel Bi 2 O 3 /BiO 1.3 I 0.4 heterojunction was synthesized using a facile solvothermal approach and used for the first time for non-radical activation of PS to degrade propranolol (PRO) in the presence of visible light. The findings found that the degradation rate of PRO in the Bi 2 O 3 /BiO 1.3 I 0.4 /PS system was significantly increased from 19% to more than 90% within 90 min compared to the Bi 2 O 3 /BiO 1.3 I 0.4 system. This indicated that the composite system exerted an excellent synergistic effect between the photocatalyst and the persulfate-based oxygenation. Quenching tests and electron paramagnetic resonance demonstrated that the non-radical pathway with singlet oxygen as the active species played a major role in the photocatalytic process. The existence of photo-generated holes during the reaction could also be directly involved in the oxidation of pollutants. Meanwhile, a possible PRO degradation pathway was also proposed. Furthermore, the impacts of pH, humic acid and common anions on the PRO degradation by the Bi 2 O 3 /BiO 1.3 I 0.4 /PS were explored, and the system's stability and reusability were also studied. This study exhibits a highly productive catalyst for PS activation via a non-radical pathway and provides a new idea for the degradation of PRO. [Display omitted] [ABSTRACT FROM AUTHOR]

Delandistrogene moxeparvovec is a gene transfer therapy approved in the United States, United Arab Emirates, and Qatar for the treatment of ambulatory patients aged four through five years with a confirmed Duchenne muscular dystrophy (DMD)-causing mutation in the DMD gene. This therapy was developed to address the underlying cause of DMD through targeted skeletal, respiratory, and cardiac muscle expression of delandistrogene moxeparvovec micro-dystrophin, an engineered, functional dystrophin protein. Drawing on clinical trial experience from Study 101 (NCT03375164), Study 102 (NCT03769116), and ENDEAVOR (Study 103; NCT04626674), we outline practical considerations for delandistrogene moxeparvovec treatment. Before infusion, the following are recommended: (1) screen for anti-adeno-associated virus rhesus isolate serotype 74 total binding antibody titers <1:400; (2) assess liver function, platelet count, and troponin-I; (3) ensure patients are up to date with vaccinations and avoid vaccine coadministration with infusion; (4) administer additional corticosteroids starting one day preinfusion (for patients already on corticosteroids); and (5) postpone dosing patients with any infection or acute liver disease until event resolution. Postinfusion, the following are recommended: (1) monitor liver function weekly (three months postinfusion) and, if indicated, continue until results are unremarkable; (2) monitor troponin-I levels weekly (first month postinfusion, continuing if indicated); (3) obtain platelet counts weekly (two weeks postinfusion), continuing if indicated; and (4) maintain the corticosteroid regimen for at least 60 days postinfusion, unless earlier tapering is indicated. Although the clinical safety profile of delandistrogene moxeparvovec has been consistent, monitorable, and manageable, these practical considerations may mitigate potential risks in a real-world clinical practice setting. [ABSTRACT FROM AUTHOR]

• Nutrition care should be individualized using clinical data and goals of PwCF. • Consider potential CV complications associated with the legacy, high fat/high calorie CF diet. • FI is a concern in PwCF from all socioeconomic sectors and screening should be part of standard. • There is a lack of data to make specific suggestions about salt intake in those PwCF and hypertension. • Inline enzyme cartridges are effective for digesting nutrients and promoting weight gain in PwCF. To provide interim advice and considerations to the CF Community around CF nutrition in the current era. The Cystic Fibrosis (CF) Foundation organized a multidisciplinary committee to develop a Nutrition Position Paper based on the rapidly changing nutrition landscape in CF, due in part to widespread use of cystic fibrosis transmembrane regulator highly effective modulator therapy (HEMT). Four workgroups were formed: Weight Management, Eating Behavior/Food Insecurity, Salt Homeostasis and Pancreatic Enzyme use. Each workgroup conducted their own focused review of the literature. The committee summarized current understanding of issues pertaining to the four workgroup topics and provided 6 key take-aways around CF Nutrition in the new era. People with CF (pwCF) are living longer, particularly with the advent of HEMT. The traditional high fat, high calorie CF diet may have negative nutritional and cardiovascular consequences as pwCF age. Individuals with CF may have poor diet quality, food insecurity, distorted body image, and an higher incidence of eating disorders. An increase in overweight and obesity may lead to new considerations for nutritional management, given potential effects of overnutrition on pulmonary and cardiometabolic parameters. [ABSTRACT FROM AUTHOR]

Understanding iodine deficiency (ID) burdens and trends in Asia can help guide effective intervention strategies. This study aims to report the incidence, prevalence, and disability-adjusted life years (DALYs) of ID in 48 Asian countries during the period 1990–2019. Data on ID were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and estimated by age, sex, geographical region, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) was calculated to evaluate the changing trend of age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate (ASDR) related to ID during the period 1990–2019. In Asia, there were 126,983,965.8 cases with 5,466,213.1 new incidence and 1,765,995.5 DALYs of ID in 2019. Between 1999 and 2019, the EAPC in ASIR, ASPR and ASDR were −0.6 (95% confidence interval [CI], −0.8 to −0.4), −0.9 (95% CI, −1.2 to −0.7), and −1.6 (95% CI, −1.8 to −1.5), respectively. Malaysia charted the largest decrease in ASIR, ASPR, and ASDR (82.4%, 85.3%, and 80.9% separately), whereas the Philippines and Pakistan were the only two countries that witnessed an increase in ASIR and ASPR. ID burdens were more pronounced in women, countries located to the south of the Himalayas, and low-middle SDI regions. The incidence, prevalence, and DALYs of ID in Asia substantially decreased from 1990 to 2019. Women and low-middle SDI countries have relatively high ID burdens. Governments need to pay constant attention to the implementation and monitoring of universal salt iodization. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus-2 raised in 2019 (COVID-19) affects the lung tissue and other organs, specifically the heart. The current study evaluated 120 hospitalised patients with severe COVID-19 between March 2021 and February 2022. Patients' demographics, vital signs, electrocardiogram abnormalities, clinical laboratory tests, including troponin I (TPI), mortality, and discharge type, were recorded. Among the 120 hospitalised patients with severe COVID-19, 54 (45.0%) patients were male, with an average age of 63.2 ± 1.4. Many patients have chronic comorbidities, including hypertension (51.6%), diabetes mellitus (34.1%), and ischemic heart disease (17.5%). The in-hospital and six months after the discharge mortality were 45.8% and 21.5%, respectively. Cardiac injury was observed in 14 (11.7%) patients with a mean TPI level of 8.386 ± 17.89 μg/L, and patients with cardiac injury had higher mortality than those without cardiac injury (P < 0.001). Furthermore, the cardiac injury was meaningfully correlated with age (ρ = 0.182, P = 0.019), history of ischemic heart disease (ρ = 0.176, P = 0.05), hospitalisation result and mortality (ρ = 0.261, P = 0.004), inpatient in ICU (ρ = 0.219, P = 0.016), and serum levels of urea (ρ = 0.244, P = 0.008) and creatinine (ρ = 0.197, P = 0.033). Additionally, the discharge results were significantly correlated with oxygen saturation with (ρ = −0.23, P = 0.02) and without (ρ = −0.3, P = 0.001) oxygen therapy, D-dimer (ρ = 0.328, P = 0.019), LDH (ρ = 0.308, P = 0.003), urea (ρ = 0.2, P = 0.03), and creatinine (ρ = 0.17, P = 0.06) levels. Elevated TPI levels are associated with increased mortality in severe COVID-19 patients. Therefore, TPI may be a beneficial biofactor for early diagnosis of cardiac injury and preventing a high mortality rate. [ABSTRACT FROM AUTHOR]

With photon-counting CT, spectral imaging is always available, and iodine maps with high spatial and spectral resolution can be generated. The aim of this study was to investigate whether iodine uptake in different parenchymal patterns can be used to characterise parenchymal disease with increased lung attenuation. 325 patients were scanned with a photon-counting CT using four scan protocols, all with lung parenchymal contrast. Lesions were classified into three basic patterns: consolidation, ground-glass opacities (GGO), and reticular pattern. Lesion classification was performed by 2 of 3 radiologists who were blinded to the diagnosis. Classification was performed twice using a 5-point Likert scale (with and without iodine maps). In case of disagreement, a third reader was consulted, and the decision was made by consensus. 206 lesions were found with a confirmed diagnosis (83 consolidations, 72 GGO, and 51 reticular). Diagnostic confidence improved when iodine maps were included in the evaluation. The mean Likert score increased significantly for all three basic patterns (consolidations: 3.3 vs. 3.9, GGO: 3.4 vs. 4.1, and reticular: 3.6 vs. 4.4, p < 0.001). However, the score for GGO and reticular pattern was downgraded in three and one cases, respectively. The downgrading occurred for morphologically uncertain GGO findings (3) and atelectasis (1) with inhomogeneous iodine uptake. In 29 lesions, the classification was changed when the iodine maps were included in the evaluation. Including iodine maps adds contrast uptake information and improves the diagnostic confidence of radiologists in the characterization of parenchymal pathologies. Iodine maps have the potential to provide complementary information for the interpretation of lung opacities with overlapping morphology. [ABSTRACT FROM AUTHOR]

• The ORR of ABCP/ECT for T -SCLC exceeds 70 %, with a mPFS of 5.1 m. • PD-L1 inhibitor-based combination therapy significantly prolonged pOS of T -SCLC. • Combination immunotherapy could serve as a potential treatment option for T -SCLC. • Upregulation of SFTPA1, EGFR L858R, or PD-L1 ≥ 1 % may benefit these patients. Transformed small-cell lung cancer (T -SCLC) has an extremely poor prognosis, and no remedies based on immunotherapy have been evaluated among T -SCLC patients. We retrospectively analysed the efficacy and safety of combining atezolizumab with chemotherapy for T -SCLC. Forty-seven patients harbouring EGFR mutations who developed T -SCLC were enrolled. Eleven patients who used immunotherapy were defined as the I/O group, and the remaining 36 were defined as the Non-I/O group. Clinical characteristics, pathological data, and survival outcomes were collected. RNA sequencing and whole-exome sequencing (WES) were performed for in-depth analysis. All patients received at least one line of EGFR-TKI before rebiopsy to confirm T -SCLC. Nine patients received atezolizumab-bevacizumab-carboplatin-paclitaxel (albumin-bound) (ABCP), and the remaining 2 received atezolizumab-etoposide-carboplatin (ECT) in the I/O group. The objective response rate was 73 % (8/11). The median progression-free survival (mPFS) of T -SCLC on post-transformation therapy with I/O group and Non-I/O group was 5.1 m and 4.1 m, respectively. The median post- T -SCLC overall survival of the I/O group was significantly longer than that Non-I/O group (20.2 m vs 7.9 m, P ＜ 0.01). T -SCLC harbouring EGFR L858R tended to be longer than EGFR 19del (mPFS: not reached vs 3.7 m, P = 0.11). Positive PD-L1 status was also associated with PFS benefits (mPFS: 6.0 m vs 3.7 m, P = 0.20). Furthermore, RNA sequencing revealed that expression of SFTPA1 is significantly higher in the durable clinical benefit group. WES showed that STC2 mutation is more frequently observed at the time-point immunotherapy acquired resistance. Combination therapy based on a PD-L1 inhibitor was well tolerated, and the safety profile was consistent with previously reported studies. Our study first demonstrated that a PD-L1 inhibitor combined with chemotherapy ± bevacizumab could be a potential safe option for specific SCLC-transformed patients. Subsequent studies with more patients are essential to verify the efficacy and potential biomarkers. [ABSTRACT FROM AUTHOR]

Background: The relationship between iodine intake and depression is unknown. The aim of the present study was to investigate whether iodine intake was associated with symptoms of perinatal emotional distress and depression in a mild- to moderately iodine deficient population.Methods: The study population comprised 67,812 women with 77,927 pregnancies participating in the Norwegian Mother, Father and Child Cohort Study. Self-reported emotional distress and depressive symptoms were reported in pregnancy and at six months postpartum. Iodine intake was assessed by a food frequency questionnaire in mid-pregnancy. Urinary iodine concentration (UIC) was available for 2792 pregnancies.Results: The median iodine intake from food was 121 μg/day and the median UIC was 68 μg/L. The prevalence of high scores for emotional distress was 6.6 % in pregnancy and 5.8 % six months postpartum, and for high scores on postpartum depression it was 10.3 %. In non-users of iodine supplements (63 %), a low maternal iodine intake from food (lower than ~100-150 μg/day) was associated with increased risk of high scores of emotional distress and depression both in pregnancy and six months postpartum (p < 0.001). Iodine supplement use was associated with increased risk of high scores of emotional distress in pregnancy compared to no supplement use or use of supplements without iodine.Limitations: Observational design, self-report information, and short scales to assess symptoms of emotional distress and depression.Conclusion: A low habitual iodine intake was associated with increased prevalence of perinatal emotional distress and depression. The potential non-beneficial effect of iodine supplements may have biological explanations. More studies are needed. [ABSTRACT FROM AUTHOR]

A healthy diet before and during pregnancy is beneficial in acquiring essential B vitamins involved in 1-carbon metabolism, and in maintaining a healthy gut microbiota. Each play important roles in fetal development, immune-system remodeling, and pregnancy-nutrient acquisition. Evidence shows that there is a reciprocal interaction between the one-carbon metabolism and the gut microbiota given that dietary intake of B vitamins has been shown to influence the composition of the gut microbiota, and certain gut bacteria also synthesize B vitamins. This reciprocal interaction contributes to the individual's overall availability of B vitamins and, therefore, should be maintained in a healthy state during pregnancy. There is an emerging consensus that obese pregnant women often have derangements in 1-carbon metabolism and gut dysbiosis owing to high intake of nutritiously poor foods and a chronic systemic inflammatory state. For example, low folate and vitamin B12 in obese women coincide with the decreased presence of B vitamin-producing bacteria and increased presence of inflammatory-associated bacteria from approximately mid-pregnancy. These alterations are risk factors for adverse pregnancy outcomes, impaired fetal development, and disruption of fetal growth and microbiota formation, which may lead to potential long-term offspring metabolic and neurologic disorders. Therefore, preconceptional and pregnant obese women may benefit from dietary and lifestyle counseling to improve their dietary nutrient intake, and from monitoring their B vitamin levels and gut microbiome by blood tests and microbiota stool samples. In addition, there is evidence that some probiotic bacteria have folate biosynthetic capacity and could be used to treat gut dysbiosis. Thus, their use as an intervention strategy for obese women holds potential and should be further investigated. Currently, there are many knowledge gaps concerning the relationship between one-carbon metabolism and the gut microbiota, and future research should focus on intervention strategies to counteract B vitamin deficiencies and gut dysbiosis in obese pregnant women, commencing with the use of probiotic and prebiotic supplements. [ABSTRACT FROM AUTHOR]

To recognize the spatial and temporal characteristics of iodine deficiency disorders (IDD), China national IDD surveillance data for the years of 1995–2018 were analyzed. Time series analysis was used to describe and predict the IDD related indicators, and spatial analysis was used to analyze the spatial distribution of salt iodine levels. In China, the median urinary iodine concentration increased in 1995–1997, then decreased to adequate levels, and are expected to remain appropriate in 2019–2022. The goiter rate continually decreased and is expected to be maintained at a low level. Since 2002, the coverage rates of iodized salt and the consumption rates of qualified iodized salt (the percentage of qualified iodized salt in all tested salt) increased and began to decline in 2012; they are expected to continue to decrease. Spatial epidemiological analysis indicated a positive spatial correlation in 2016–2018 and revealed feature regarding the spatial distribution of salt related indicators in coastal areas and areas near iodine-excess areas. Iodine nutrition in China showed gradual improvements. However, a recent decline has been observed in some areas following changes in the iodized salt supply in China. In the future, more regulations regarding salt management should be issued to strengthen IDD control and prevention measures, and avoid the recurrence of IDD. [ABSTRACT FROM AUTHOR]

With the development of synthesis technology, modified messenger RNA (mRNA) has emerged as a novel category of therapeutic agents for a broad of diseases. However, effective intracellular delivery of mRNA remains challenging, especially for its sensitivity to enzymatic degradation. Here, we propose a polyphenol-assisted handy delivery strategy for efficient in vivo delivery of IL-10 mRNA. IL-10 mRNA binds to polyphenol ellagic acid through supramolecular binding to yield a negatively charged core, followed by complexing with linear polyetherimide and coating with bilirubin-modified hyaluronic acid to obtain a layer-by-layer nanostructure. The nanostructure specifically up-regulated the level of IL-10, effectively inhibited the expression of inflammatory factors, promoted mucosal repair, protected colonic epithelial cells against apoptosis, and exerted potent therapeutic efficacy in dextran sulfate sodium salt-induced acute and chronic murine models of colitis. The designed delivery system without systemic toxicity has the potential to facilitate the development of a promising platform for mRNA delivery in ulcerative colitis treatment. The polyphenol-assisted IL-10 mRNA delivery system with self-protection and active targeting mechanisms. Through rectal administration, this delivery system achieved conspicuous therapeutic effect on dextran sulfate sodium salt-induced ulcerative colitis model. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Iodine status surveys of women in Somaliland present widely conflicting results. Previous research indicates elevated concentrations of iodine (IQR 18-72 μg/L) in groundwater used for drinking and cooking, but the relation with iodine intake is not well characterized.Objectives: We aimed to investigate the contributions of household water iodine concentration (WIC), breastfeeding, total fluid intake, hydration levels, and urine volume on urinary iodine concentration (UIC) and excretion (UIE) over a 24-h period and to define iodine status from iodine intake estimates and median UIC, normalized to a mean urine volume of 1.38 L/d (hydration adjusted).Methods: The study sample comprised 118 nonpregnant, healthy women aged 15-69 y. All participants resided in Hargeisa, and 27 were breastfeeding. Data collection consisted of a 24-h urine collection, a 24-h fluid intake diary, a beverage frequency questionnaire, and a structured recall interview. We measured UIC and WIC in all urine and in 49 household water samples using the Sandell-Kolthoff reaction.Results: WIC ranged between 3 and 188 μg/L, with significant median differences across the water sources and city districts (P < 0.003). Nonbreastfeeding women were borderline iodine sufficient [hydration-adjusted median urinary iodine concentration (mUIC) 109 μg/L; 95% CI: 97, 121 μg/L], whereas breastfeeding women showed a mild iodine deficiency (73 μg/L; 95% CI: 54, 90 μg/L). There were strong correlations (ρ: 0.50-0.69, P = 0.001) between WIC and UIC, with iodine from household water contributing more than one-half of the total iodine intake. Multivariate regression showed hydration and breastfeeding status to be the main predictors of UIC.Conclusions: Iodine from household water is the main contributor to total iodine intake among women in Hargeisa, Somaliland. Variation in female hydration and spatial and temporal WIC may explain diverging mUIC between studies. Water sources at the extremes of low and high iodine concentrations increase the risk of subpopulations with insufficient or more than adequate iodine intake. [ABSTRACT FROM AUTHOR]

Background: Whereas the adverse effects of severe iodine deficiency during pregnancy are well documented, the effects of mild-to-moderate deficiency are not well established.Objectives: We aimed to explore whether iodine nutrition and timing of iodine supplement initiation are associated with thyroid function in pregnant and postpartum women.Methods: In this cohort study, 137 pregnant women were enrolled and followed up at gestational weeks (GWs) 18 and 36, and 3 and 6 mo postpartum. Thyroid function tests [thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4)], urinary iodine and creatinine concentration (UIC:Cr), and iodine intake (including iodine supplement use) were measured at each time point. The associations between thyroid hormone concentrations and UIC:Cr, iodine intakes, and iodine supplement use were estimated using multiple generalized estimating equation models.Results: The median UIC at GW18 was 94 μg/L, indicating mild-to-moderate iodine deficiency. UIC:Cr (β; 95% CI) per 100 μg/g was negatively associated with fT3 (-0.191; -0.331, -0.051) and fT4 (-0.756; -1.372, -0.141) concentrations. Iodine intake (β; 95% CI) per 100 μg/d was positively associated with TSH (0.099; 0.022, 0.177), and negatively associated with fT3 (-0.084; -0.0141, -0.027) and fT4 (-0.390; -0.599, -0.182) concentrations. Compared with no use of supplement, those initiating an iodine-containing supplement prepregnancy and continuing through pregnancy had lower TSH (estimated means) (1.35 compared with 1.68 mIU/L, P = 0.021), and higher fT3 (4.48 compared with 4.28 pmol/L, P = 0.035) and fT4 (15.2 compared with 14.4 pmol/L, P = 0.024) concentrations.Conclusions: Lower iodine availability during pregnancy and postpartum was associated with lower TSH, and higher fT3 and fT4 concentrations. The use of an iodine-containing supplement that was initiated prepregnancy and continuing through pregnancy was associated with lower TSH, and higher fT3 and fT4 concentrations, which may suggest improved thyroid function. These findings support the notion that optimization of iodine intake should start before pregnancy.This trial was registered at clinicaltrials.gov as NCT02610959. [ABSTRACT FROM AUTHOR]

Background: Choledochal cysts are congenital anomalies that can occur at any level of the biliary tree. They carry long-term risk of biliary complications and cancer development. Complete excision of all involved bile ducts is recommended.Methods: Patients treated between 1995 and 2019 were reviewed retrospectively.Results: Sixty patients; 46 female and 14 male with a median age of 41 years (range 13-83) were included in the study. Mild abdominal pain was the most common presenting symptom (60%). Majority of the patients had Todani type I cysts (67%). Concomitant biliary malignancy was diagnosed in five patients (9%). Eight patients were followed-up conservatively (13%). Twenty-five patients were treated by excision of the extrahepatic bile ducts and Roux-en-Y hepaticojejunostomy, liver resection was added in seven, pancreatoduodenectomy was done in three and liver transplantation in one. There was no perioperative mortality. Postoperative complications developed in 17 patients (34%), two requiring surgical treatment. Four of the five patients with malignancies died at a median 42 months (range 6-95) following surgery. Median 62 months (range 8-280) follow-up was available in 45 surgically treated patients, 19 followed-up for more than 10 years. None of the patients developed malignancy during follow-up. Four patients (17%) were readmitted for anastomotic strictures requiring treatment.Conclusion: The majority of choledochal cysts are Todani type-I and early cyst excision is the mainstay of management, which may decrease the risk of malignant transformation. [ABSTRACT FROM AUTHOR]

• With its novel detector technology, Photon counting CT offers inherent spectral contrast, which can be utilized for virtual monoenergetic imaging, virtual non-contrast and iodine maps. • Photon counting CT derived virtual monoenergetic images can reduce beam- hardening artifacts in thoracic imaging and optimize image quality. • In subjective artifact assessment pronounced and severe artifacts were completely suppressed for all evaluated areas at 120 keV. Aim of the recent study is to point out a method to optimize quality of CT scans in oncological patients with port systems. This study investigates the potential of photon counting computed tomography (PCCT) for reduction of beam hardening artifacts caused by port-implants in chest imaging by means of spectral reconstructions. In this retrospective single-center study, 8 ROIs for 19 spectral reconstructions (polyenergetic imaging, monoenergetic reconstructions from 40 to 190 keV as well as iodine maps and virtual non contrast (VNC)) of 49 patients with pectoral port systems undergoing PCCT of the chest for staging of oncologic disease were measured. Mean values and standard deviation (SD) Hounsfield unit measurements of port-chamber associated hypo- and hyperdense artifacts, bilateral muscles and vessels has been carried out. Also, a structured assessment of artifacts and imaging findings was performed by two radiologists. A significant association of keV with iodine contrast as well as artifact intensity was noted (all p < 0.001). In qualitative assessment, utilization of 120 keV monoenergetic reconstructions could reduce severe and pronounced artifacts completely, as compared to lower keV reconstructions (p < 0.001). Regarding imaging findings, no significant difference between monoenergetic reconstructions was noted (all p > 0.05). In cases with very high iodine concentrations in the subclavian vein, image distortions were noted at 40 keV images (p < 0.01). The present study demonstrates that PCCT derived spectral reconstructions can be used in oncological imaging of the thorax to reduce port-derived beam-hardening artefacts. When evaluating image data sets within a staging, it can be particularly helpful to consider the 120 keV VMIs, in which the artefacts are comparatively low. [ABSTRACT FROM AUTHOR]

Milk and dairy products are considered important sources of iodine in several countries. Despite this, there is a paucity of studies that have investigated sources of variation of milk iodine, especially on a large scale. So far, it is not clear if milk iodine content could be increased through breeding in dairy cattle. Recently, a mid-infrared spectroscopy prediction model has been developed for an indirect quantification of iodine content in cow milk, as it is a faster and less expensive method that allows the prediction at population level. The model has coefficient of determination and ratio of performance to deviation in external validation of 0.57 and 1.44, respectively, and it was used in the present study to predict the iodine content from historical milk spectral data to investigate phenotypic and genetic aspects in the Italian Holstein cattle. Based on the accuracy of the model, the prediction was interpreted as proxy for the real milk iodine concentration (IOD P). The data set comprised 33,776 test-day records with IOD P from 4,072 cows. Data of IOD P were transformed through natural logarithm to achieve a normal distribution. The effect of parity, lactation stage, and month of sampling were investigated, and genetic parameters were estimated using a test-day repeatability animal model. Milk IOD P decreased with parities and was the lowest in early lactation. Heritability of IOD P was low (0.025) and it was positively genetically correlated with milk yield and negatively with fat content. Results suggested that it would be challenging to directly improve this trait through breeding strategies in dairy cattle, because IOD P is mainly affected by temporary environmental factors and thus, cannot be easily improved through genetics. Although preliminary, findings of this study suggest that it would be more convenient to develop feeding and management strategies to drive milk iodine level than to put efforts and resources into breeding strategies. Further studies should validate IOD P as an indicator trait of milk iodine content by improving reference data and estimating genetic correlation between predicted and measured values. [ABSTRACT FROM AUTHOR]

Incidences of anorectal malformations (ARM) occur in 1 of 2000–5000 live births and up to 64% have associated malformations (ARMa). The aim of the study was to evaluate possible prenatal risk factors for ARM in a tertiary hospital. A case–control design was used to compare risk factors in ARM (n = 44) to a control group (CG; n = 26). We used modified prenatal questionnaires, analyzed mothers' prenatal records and participants completed a structured interview. Endpoints were medical history, drug consumption, occupational risk factors, and time point of diagnosis, associated malformations and sensitivity of radiological imaging. Our results showed that ARM couples had a significantly higher age difference (p = 0.028) compared to CG. ARM mothers had more abnormalities during pregnancy (p = 0.002), more positive vaginal smears of group B streptococci (p = 0.024), urogenital infections (p = 0.005), gestosis (p = 0.03), emesis (p = 0.025) and higher numbers of chronic diseases (p = 0.018). ARM mothers took less medication during pregnancy (p = 0.013) than CG mothers including folic acid (p = 0.041); their intake of iodine tablets was significantly higher (p = 0.035) and they continued smoking for longer (p = 0.036) than CG mothers, and they had more stillbirths (p = 0.035). In using illegal drug and alcohol use, the groups did not show significant differences. ARMa was present in 68.1% (n = 30), of which 45.5% were of urogenital origin (n = 20). ARM diagnosis was made on the first day of life in 72.7% (n = 32), while diagnosis was delayed in 12 patients (27.3%). A combination of different risk factors seem to be associated with the development of ARM, which takes place at an early stage (<7th week) of pregnancy. Therefore, risk factors influencing fetal development must be critically considered. We advocate an interdisciplinary assessment in unclear clinical findings on first day of life to optimize the therapy and positively influence the outcome. [ABSTRACT FROM AUTHOR]

Sympathergic hyperactivity is considered one of the main trigger precipitating takotsubo syndrome (TTS). Chromogranin-A (CgA), a prognostic biomarker of sympatho-adrenal activation, is markedly high in acute coronary syndrome (ACS) and heart failure (HF), but its role in TTS is unknown. CgA serum levels from patients with TTS and symptoms onset <24 hours were consecutively evaluated and compared with anterior ST-elevation myocardial infarction (STEMI) patients from November 2016 to December 2019. Short and long-term follow-up data were recorded. Eleven women with TTS and 10 subjects with anterior STEMI were analyzed and compared; differences were not significant in terms of age, gender and cardiovascular risk factors. NT-pro-BNP levels were similar (9,887 ± 12,170 vs 8,969 ± 15,053 pg/ml, p =.88), while troponin-I levels were higher in patients with STEMI (4 ± 3.2 vs 13.3 ± 10 ng/dl, p =.03). CgA admission levels were significantly lower in TTS patients (2.2 ± 1.5 vs 7.3 ± 6.2 nMol/l, p =.017), even after multivariable correction for principal bias. CgA levels correlated with NTproBNP levels (p =.02) and were higher in subjects with in-hospital events (3.7 ± 1.1 vs 1.6 ± 1.2 nMol/l, p =.03), even after multivariable forward stepwise analysis (p <.01). CgA levels <3.25 nMol/l (AUC 0.754, 95% C.I. 0.54–0.968) were able to discriminate TTS from anterior STEMI (negative predictive power of 99%). Systemic CgA levels in the acute phase of TTS are lower than in anterior STEMI, possibly indicating a greater myocardial catecholamine release rather than adrenal. • Catecholamines are thought to trigger takotsubo syndrome (TTS), but only a minority of patients presents elevated levels • Chromogranin-A (CgA) is a secretagogues of catecholamines. Admission levels of CgA in TTS are lower than in anterior STEMI • Admission CgA levels could differentiate the diagnosis of TTS from STEMI significantly better than troponin and NT-pro-BNP [ABSTRACT FROM AUTHOR]

We reviewed and analyzed the most effective methods to reduce infectious complications (IC) after transrectal prostate biopsy (TRPB). We included only prospective randomized-controlled trials in the analysis. The analysis neither demonstrated any superiority of fluoroquinolones over other antibiotic classes nor of targeted antibiotics over empiric regimens in men undergoing TRPB. However, longer course antibiotics (3 days or more) compared to single dose or day regimens, combination of fluoroquinolones with aminoglycosides compared to fluoroquinolones alone and povidone-iodine rectal cleansing compared to control significantly reduced IC following TRPB. A combination of addition of aminoglycosides to oral antibiotics for 3 days along with povidone-iodine rectal cleansing may be an optimum strategy to minimize the risk of IC after TRPB. [ABSTRACT FROM AUTHOR]

Background: Severe iodine deficiency or excess during pregnancy can cause congenital hypothyroidism (CH). Iodine deficiency is common in pregnant women in the United States.Objectives: We conducted a nested case-control study in a cohort of ∼2.5 million births in California to determine whether iodine status is related to CH in a US population.Methods: Dried blood spots from 907 newborns with CH identified by newborn screening and 909 unaffected controls matched by month of birth were obtained from the California Newborn Screening Program to measure whole-blood iodine concentration. Iodine status was compared between cases and controls, and logistic regression was used to assess the association between CH status and blood iodine concentrations. Iodine status was also compared between cases and controls among infants treated in a neonatal intensive care unit (NICU) because CH has been reported in infants exposed to high levels of iodine in the NICU.Results: Blood iodine concentrations did not differ significantly between cases (median: 20.0 ng/mL; IQR: 12.1-29.8 ng/mL) and controls (median: 20.3 ng/mL; IQR: 12.5-30.9 ng/mL; P = 0.59). Neither extremely high nor extremely low blood iodine concentrations (1st, 5th, 95th, and 99th percentiles of the distribution) were more common in cases. Among infants treated in NICUs, however, cases had significantly (P = 0.01) higher iodine (median: 22.7 ng/mL; IQR: 16.4-32.1 ng/mL) compared with controls (median: 17.3 ng/mL; IQR: 8.3-26.6 ng/mL).Conclusions: CH cases did not have significantly higher or lower iodine in this population, which is reassuring given that maternal iodine deficiency is common in the United States. Among newborns in the NICU, CH cases had higher blood iodine concentrations compared with controls, suggesting that excess iodine exposure in the NICU could be causing CH. It may be beneficial to monitor iodine exposure from surgical procedures, imaging, and iodine-containing disinfectants and to consider non-iodine alternatives. [ABSTRACT FROM AUTHOR]

The brown seaweed Ascophyllum nodosum is known to bioaccumulate iodine (I). Previous research showed a linear relationship between A. nodosum meal (ASCO) intake and milk I concentration in dairy cows. Thus, improving milk I concentration by supplementation of ASCO to dairy cows may be a compelling strategy to naturally boost I intake in humans. A sensitivity analysis was conducted to gain insights regarding how different milk I intakes affect the I status of pregnant women relative to the United States Institute of Medicine (US IOM) recommended dietary allowance (RDA; 220 µg/d) and the World Health Organization (WHO) recommended nutrient intake (RNI; 250 µg/d) for I. Four studies in which dairy cows received various amounts of ASCO generated the milk I data set used in the sensitivity analysis. The annual per capita consumption of 2% reduced-fat milk in the United States, converted to daily intake (i.e., 0.26 cup; 1 cup = 236.6 mL), was used as the actual milk intake in the simulations. Five additional milk intake scenarios (2, 3, 4, and 5 times the actual per capita milk consumption and the 3 cups-equivalent recommended by the 2015–2020 Dietary Guidelines for American were also included in the sensitivity analysis with varying milk I concentrations (180, 765, and 483 µg/L). The 180, 765, and 483 µg/L values are milk I concentrations derived from cows not receiving ASCO or fed various amounts of ASCO in the diet or a single level (113 g/d) during the grazing season, respectively. With the actual United States milk per capita consumption of 0.26 cup/d and milk I concentrations of 180, 765, and 483 µg/L, 5.09, 21.7, and 13.6% of the RDA for I for pregnant women were met based on the US IOM, respectively. Similarly, 4.48, 19, and 12% of the RNI for I advised by the WHO was achieved with intake of 0.26 cup/d of milk containing I concentrations of 180, 765, and 483 µg/L, respectively. When 3 cups/d was included in the simulations, 58.2, 247, and 156% (US IOM), and 51.2, 217, and 137% (WHO) of the RDA or RNI for I required by gestating women was satisfied with milk I concentrations of 180, 765, and 483 µg/L, respectively. A regression analysis between I intake and milk I concentration revealed that 103 g/d of ASCO in the diet of dairy cows reached the maximum 500 µg/L threshold of I in milk recommended by the European Food Society Authority. Overall, milk from dairy cows fed ASCO can prevent I deficiency in pregnant women, but the amount of ASCO fed to cows needs to be fine-tuned to avoid excess I in milk. Further research is required to better understand the interactions between goitrogenic compounds from forages and concentrates and milk I concentration in cows fed ASCO. Research to evaluate the concentration of I in retail organic milk should be also conducted because of the high prevalence of ASCO fed in organic dairies in the United States. [ABSTRACT FROM AUTHOR]

Background Mild-to-moderate iodine deficiency, particularly in pregnancy, is prevalent; this is of concern because observational studies have shown negative associations with child neurodevelopment. Although neither the benefits nor the safety of iodine supplementation in pregnancy in areas of mild-to-moderate deficiency are well researched, such supplementation is increasingly being recommended by health authorities in a number of countries. Objectives By reviewing the most recent published data on the effects of iodine supplementation in mildly-to-moderately deficient pregnant women on maternal and infant thyroid function and child cognition, we aimed to determine whether the evidence was sufficient to support recommendations in these areas. Methods A systematic review of randomized controlled trials (RCTs), non-RCT interventions, and observational studies was conducted. To identify relevant articles, we searched the PubMed and Embase databases. We defined mild-to-moderate iodine deficiency as a baseline median urinary iodine concentration (UIC) of 50–149 µg/L. Eligible studies were included in meta-analyses. Results In total, 37 publications were included—10 RCTs, 4 non-RCT interventions, and 23 observational studies. Most studies showed no effect of iodine supplementation on maternal or infant thyroid-stimulating hormone and free thyroxine. Most RCTs found that supplementation reduced maternal thyroglobulin and in 3 RCTs, it prevented or diminished the increase in maternal thyroid volume during pregnancy. Three RCTs addressed child neurodevelopment; only 1 was adequately powered. Meta-analyses of 2 RCTs showed no effect on child cognitive [mean difference (MD): −0.18; 95% CI: −1.22, 0.87], language (MD: 1.28; 95% CI: −0.28, 2.83), or motor scores (MD: 0.28; 95% CI: −1.10, 1.66). Conclusions There is insufficient good-quality evidence to support current recommendations for iodine supplementation in pregnancy in areas of mild-to-moderate deficiency. Well-designed RCTs, with child cognitive outcomes, are needed in pregnant women who are moderately deficient (median UIC < 100 µg/L). Maternal intrathyroidal iodine stores should be considered in future trials by including appropriate measures of preconceptional iodine intake. This review was registered at www.crd.york.ac.uk/prospero as CRD42018100277. [ABSTRACT FROM AUTHOR]

• Foliar application of iodine is effective for iodine accumulation in tomato fruit. • 1 mM KIO 3 solution was the most suitable rate for tomato biofortification. • Foliar application localized on the leaves close to the fruit maximizes its iodine concentration. • Rates of KIO 3 solution less than or equal to 5 mM do not affect yield and plant health. • Iodine application can improve the nutritional profile of tomatoes. Iodine is an essential mineral for the human body and inadequate intake causes iodine deficiency disorders (IDDs) worldwide. Agronomic biofortification is a promising complementary approach to other strategies to avoid IDDs. It consists of the enrichment of fruit and vegetables with nutritional elements through preharvest techniques. Tomato is an important, nutritious, and widely consumed crop. Despite a poor iodine accumulation in the fruit, tomato is an iodine accumulator. Our research focused on iodine enrichment of two table tomato types (cherry and mini-plum) in a commercial mediterranean greenhouse. Potassium iodate (KIO 3) was applied four times through foliar spray at three concentrations (0, 1, 5 mM) at two localized sites of application (at plant apex and at the three leaves above the target truss, "target leaves") until the mature green stage of a target truss (untreated and the same for each treatment). The application of 1 mM KIO 3 solution at the target leaves was the most suitable approach for adequate fruit enrichment. The accumulation of 110 μg∙100 g−1 of fresh weight (FW) in cherry and 130 μg∙100 g−1 FW for mini-plum tomato largely satisfy the iodine recommended dietary allowance for adults, pregnant and lactating women. Plant health, yield and commercial quality of fruit (color, size, dry matter content, total soluble solids, titratable acidity, pH) were not affected, while some carotenoids and total phenolics were slightly incremented, indicating a possible positive influence on the nutritional quality. In conclusion, foliar application of iodine for the preharvest enrichment of tomato was a successful approach to biofortification in a commercial greenhouse. That suggests further research is needed to investigate and improve the iodine biofortification techniques in different crops and systems. [ABSTRACT FROM AUTHOR]

Iodine stands as a vital trace element essential crucial for synthesizing thyroid hormones, which are essential for regulating metabolism and tissue growth. The "gold standard" for assessing iodine status in a population quantifies the iodine content in urine samples and is based on Inductively Coupled Plasma - Mass Spectrometry (ICP-MS). Such method, or methods involving the readings of the Sandell-Kolthoff (S K) reaction, require complex sample preparations and the use of several toxic chemical elements. However, recent studies have shown a strong correlation between urinary iodine content (UIC) and iodine present in saliva. Using Monte Carlo simulations, this paper presents a TXRF-based method to quantify salivary iodine biomarker for assessing and monitoring iodine status. In the theoretical analysis, mono and polychromatic (filtered) excitation sources are considered. The detection and quantification limits of iodine, as well as the calibration curves for mass recovery, used the strong I K α 1 and I K α 2 lines. It was found that the optimal X-ray excitation source energy for iodine detection is 50 keV monochromatic X-rays. In contrast, using simulated spectra from a tungsten anode target, the best result was found at 70 kVp (peak voltage), after filtering the white beam with a copper absorber. Detection limits of iodine are 0.121 ng and 2.292 ng, for mono and polychromatic sources, respectively. The theoretical results of this paper show that TXRF could be a fast, simple and accurate alternative to ICP-MS or S K reaction-based methods. Of clinical significance, quantifying salivary iodine using TXRF to assess and monitor iodine status could be particularly helpful to patients undertaking 131I treatment. In addition, it could be used in epidemiological field studies to determine iodine deficiency/excess in children and pregnant women. [Display omitted] • TXRF based method for quantifying salivary iodine is simulated by Monte Carlo. • Detection limits of 0.121 ng and 2.292 ng, for mono and polychromatic X-ray beams. • TXRF could be a simple and fast alternative to ICP-MS method. • Particularly helpful to assess iodine status of patients undertaking 131I treatment. • Epidemiological field studies of iodine deficiency in children and pregnant women. [ABSTRACT FROM AUTHOR]

• Additional predictive markers besides to PD-L1 are needed to select patients with NSCLC more accurately who would benefit from ICI strategies. • High levels of HLA-I immunostaining were significantly correlated with favorable clinical outcome to ICI in our cohort. • A subset of long-term responders to ICI were enriched with high-level HLA-I-expressing tumors. • The positive association between PD-L1 with CD73 and with HLA-I expression, might determine an immune-inflamed phenotype potentially enhancing responsiveness to ICI. Immune checkpoint inhibitors (ICIs) have provided a breakthrough in the treatment of non-small cell lung cancer (NSCLC) patients, but only some patients benefit substantively. Identifying definitive predictive biomarkers could overcome this limitation. We selected 146 metastatic NSCLC patients treated with anti-PD-(L)1. Immunohistochemistry of HLA-I, PD-L1 and CD73 was performed in 122 tumor biopsies at diagnosis. The association with patients, tumor parameters, and the predictive value to ICI treatment were determined. In our cohort, 42 %, 25 %, and 21 % of the tumors exhibited high levels of HLA-I, PD-L1, and CD73, respectively. Lung adenocarcinomas displayed elevated CD73 levels, compared with lung squamous cell carcinomas (P = 0.026). High PD-L1 was significantly correlated with high levels of HLA-I (P = 0.005) and of CD73 (P = 0.025). Patients with high-level HLA-I tumors exhibited more favorable clinical outcomes following ICI, with a median overall survival of 30.7 months (95 % confidence interval [CI]: 18.3 months-not reached), compared with 18.2 months (95 % CI: 12.4–25.2 months) in patients with low-level HLA-I tumors (P = 0.016). The median progression-free survival (PFS) for patients with high-level HLA-I tumors was 18.5 months (95 % CI: 11.1–57.1 months), longer than patients with low-level HLA-I tumors, whose median PFS was 9.2 months (95 % CI: 7.2–11.9 months) (P = 0.006). In a multivariable analysis, high-level HLA-I was independently associated with lower risk of progression to ICI (HR = 0.46, 95 % CI 0.24–0.87; P = 0.018). High-level HLA-I were associated with better clinical outcomes to ICI in our cohort of NSCLC patients. Therefore, further investigations are warranted to refine this biomarker and validate its efficacy in prospective and larger set of patients. [ABSTRACT FROM AUTHOR]

• Feasibility trial of standard of care radiotherapy plus a PD-L1 inhibitor for HNSCC. • Immune-related toxicity was manageable and transient. • Radiotherapy-related toxicity was in accordance with standard of care. • Cetuximab-RT plus avelumab is feasible; data provide ground for efficacy trials. Radiotherapy (RT) with cetuximab is an alternative for advanced-stage head and neck squamous cell carcinoma (HNSCC) patients who are unfit for cisplatin treatment. As 5-year overall survival is below 50%, it is of interest to test PD-L1 immune checkpoint blockade (avelumab) with cetuximab-RT in the curative setting. Phase-I feasibility trial (planned n = 10, NCT02938273) of conventional cetuximab-RT with avelumab (concurrent 10 mg/kg Q2W + 4 months maintenance) for advanced-stage HNSCC patients unfit for cisplatin treatment. One of ten included patients experienced grade 2 cetuximab-related infusion reaction and withdrew from the study before avelumab was administered. One patient discontinued treatment after 2 courses of avelumab and 12×2Gy RT for personal reasons. In 2/8 remaining patients, avelumab was stopped after 4 and 8 courses because of toxicity and tumor progression, respectively. There was no grade 4–5 toxicity. Grade 3 immune-related toxicity was manageable and occurred in 4 patients. One patient was treated with topical steroids for grade 3 maculopapular rash and 3 patients received high-dose prednisone for grade 3 elevated liver enzymes (n = 1) and pneumonitis (n = 2). Seven patients experienced grade 3 RT-related toxicity with no severe specific cetuximab-related toxicity. Tumor recurrence occurred in 4/8 patients (50%) after a median of 12 (8–26) months follow-up. Cetuximab-RT plus avelumab is feasible in patients with advanced-stage HNSCC who are unfit for cisplatin treatment. Immune-related toxicity was transient and manageable and radiotherapy-related toxicity was in accordance with standard of care. This pilot study provides grounds for larger efficacy trials. [ABSTRACT FROM AUTHOR]

Long-term outcomes reveal equivalent biochemical outcomes with low-dose-rate (LDR) brachytherapy (BT) compared with radical prostatectomy and external-beam radiotherapy for the management of prostate cancer. Iodine-125, the most commonly used isotope, may be associated with long-term urinary consequences. Cesium-131 (131Cs) has a higher dose rate and shorter dose delivery time, predicting a shorter duration of urinary morbidity. We report our institution's high-volume experience and the most mature data to date on outcomes with 131Cs prostate BT. 571 men (median age: 65.38 years) with low (55%)-, intermediate (36%)-, and high-risk disease (9%) received monobrachytherapy, dual-modality, or trimodality using 131Cs at a single institution. Risk groups were defined according to the National Comprehensive Cancer Network definition. Median prescription dose for definitive LDR-BT and LDR-BT boost was 115 Gy and 70 Gy, respectively. Median initial PSA was 6.1 ng/mL (IQR: 4.6–8.7). Median followup time was 5 years. 5/7-year overall survival for low-, intermediate-, and high-risk patients was 96.9%/96/9%, 92.8%/89.7%, and 95.8%/87.1%, respectively (p = 0.02). 5/7-year freedom from biochemical failure for low-, intermediate-, and high-risk patients was 98.5%/96.3%, 94.1%/86.4%, and 93.2%/74.5%, respectively (p < 0.01). 5/7-year prostate cancer -specific survival was 100%/100%, 99.3%/99.3%, and 98.0%/98.0% for low-, intermediate-, and high-risk patients, respectively (p < 0.01). 131Cs is a viable alternative isotope for prostate brachytherapy for organ-confined disease. Long-term biochemical control and survival outcomes are excellent and on par with those attained with the use of 125I or 103Pd. This report therefore supports the continued use of 131Cs as an effective and comparable alternative isotope. [ABSTRACT FROM AUTHOR]

Background Population iodine deficiency is indicated by >3% of the population with newborn thyroid-stimulating hormone (TSH) concentration >5 mIU/L, median urinary iodine concentration (MUIC) <100 µg/L, or >5% prevalence of goiter in school-age children. However, the agreement between these population markers has not been systematically investigated. Objective To assess the agreement between TSH, MUIC, and goiter as markers of population iodine status. Methods We performed a systematic search for studies published on PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PsycINFO up to 29 October, 2018. Studies assessing iodine status in the population using the TSH marker and either MUIC or goiter prevalence in school-age children were included. The agreement between markers in classifying iodine status of the population was assessed. The sensitivity and specificity of the TSH marker was determined against MUIC and goiter prevalence as the reference markers. Results Of 17,435 records identified by the search strategy, 57 eligible studies were included in the review. The agreement between markers in classifying the iodine status of populations into the same category was 65% for TSH and MUIC, and 83% for TSH and goiter prevalence. The TSH marker had a sensitivity of 0.75 and specificity of 0.53 when compared with MUIC, and 0.86 and 0.50 when compared with goiter prevalence. Conclusions The TSH marker has a better agreement with goiter prevalence than MUIC when classifying the iodine status of populations. Re-evaluation of the current criteria for classifying the iodine status of populations using the TSH marker is warranted. This systematic review was registered at PROSPERO (http://www.crd.york.ac.uk/prospero/) as CRD42018091247. [ABSTRACT FROM AUTHOR]

Purpose: Dual energy CT (DECT) can contribute to the diagnosis of benign and malignant pancreatic lesions. This study examined whether a novel, detector-based spectral CT scanner (SDCT) may improve subjective assessment of different types of pancreatic lesions and if various quantitative maps may improve lesion contrast and differentiation.Materials and Methods: 61 consecutive patients who underwent clinical, contrast-agent enhanced, abdominal SDCT scans and showed pancreatic lesions of different origins were included. Subjective image analysis was performed by two readers who assessed image quality, lesion conspicuity and diagnostic confidence on 5-point Likert scales for conventional polyenergetic reconstructions (polyE), virtual monoenergetic images (monoE), virtual non-contrast images, iodine density, iodine overlay, and Z effective (Zeff) maps. Two readers acquired quantitative values from these maps ROI-based from which contrast-to-noise and lesion-to-parenchyma ratios were calculated.Results: MonoE images at low keV levels yielded highest Likert scores regarding lesion conspicuity and reader confidence; iodine overlays facilitated lesion delineation. Inter-observer agreement ranged between substantial and excellent (kappa values 0.73-0.81). Contrast-to-noise-ratios for low keV monoE images were significantly higher, compared to polyE images (e.g. monoE 40 keV p < 0.0001). Marked overlap between PDAC and miscellaneous non-PDAC lesions was present in various spectral reconstructions.Conclusions: In line with previous studies, monoE images at low keV levels and iodine overlay maps facilitated subjective lesion delineation which was substantiated by the quantitative analysis. Hence, spectral detector CT improves pancreatic lesion conspicuity, while its value for lesion differentiation needs to be further evaluated in larger study cohorts. [ABSTRACT FROM AUTHOR]

The microbiota has been identified as an important factor in health and in a variety of diseases. An altered microbiota composition increases the prevalence of Hashimoto's thyroiditis (HT) and Graves' disease (GD). Microbes influence thyroid hormone levels by regulating iodine uptake, degradation, and enterohepatic cycling. In addition, there is a pronounced influence of minerals on interactions between host and microbiota, particularly selenium, iron, and zinc. In manifest thyroid disorders, the microbiota may affect L-thyroxine uptake and influence the action of propylthiouracil (PTU). Although it is relatively well documented that thyroid disorders are linked to the composition of the microbiota, the role of specific genera and the potential use of therapies targeting the microbiota are less clear. The microbiota influences the uptake of iodine, selenium, and iron, and the microbiota may alter the availability of L-thyroxine and toxicity of PTU. Several findings, including the altered microbiota composition in patients with thyroid disorders, the prominent metabolism of thyroid hormones by the microbiota, and that germ-free rats have smaller thyroids than normal rats, support the hypothesis that the gut microbiota also plays a prominent role in thyroid function of the host. A variety of recent studies suggest that the gut microbiota has an enormous impact on human health and disease, and alimentary modulation of the gut microbiota by ingestion of pre, pro-, post-, and synbiotics has been advocated for a variety of diseases. Autoimmune thyroid disorders and metaplastic atrophic gastritis are particularly linked. [ABSTRACT FROM AUTHOR]

In the management of meningiomas invading the major venous sinuses, balance between tumor control and complication prevention is desirable. The aim of this study was to describe an institutional experience in management of meningiomas involving major venous sinuses. A retrospective study was carried out over 18 years, between 1999 and 2017, in patients with meningiomas involving major venous sinuses. Clinical features, operative strategy, histology, postoperative complications, adjuvant therapy, and long-term follow-up were studied. The study included 84 patients. Neurologic deficits were seen in 26 (31%) patients at presentation. The recurrence rates in Simpson grade I, II, and III excision were 7.6%, 25%, and 29.4% at a mean follow-up of 45.4 months (range, 1–192 months). No intervention of the involved sinus was done in 64 (76%) cases, venotomy was done in 3 (3.5%) cases, sinus resection without graft was done in 14 (16.6%) cases, and sinus reconstruction with patch was done in 3 (3.5%) cases. There were 53 (67.0%) patients with World Health Organization grade I histology and 25 (31.6%) patients with World Health Organization grade II histology. Fifteen recurrences were treated with Gamma Knife radiosurgery. In univariate analysis using Cox proportional hazards model, World Health Organization grade (P = 0.036, hazard ratio 2.90, 95% confidence interval = 1.07–7.87) and Simpson grade (P = 0.017, hazard ratio 2.90, 95% confidence interval = 1.18–5.29) were found to be significant factors to predict tumor recurrence. Management of meningiomas involving major venous sinus with microsurgical techniques and adjuvant Gamma Knife radiosurgery achieves a good tumor control rate with an acceptable complication rate. [ABSTRACT FROM AUTHOR]

Fetal programming may influence childhood and adult life, determining the risk of specific diseases. During earlier stages of pregnancy, the transfer of maternal thyroid hormones to the fetus is vital for adequate neurologic development. The presence of severe maternal thyroid dysfunction, particularly severe iodine deficiency, is devastating, leading to irreversible neurologic sequelae. Moreover, mild maternal thyroid conditions, such as a mild-to-moderate iodine deficiency, may also lead to milder neurologic and behavioral conditions later during the life of the offspring. Maternal dysglycemia due to pregestational or gestational diabetes mellitus is another common situation in which fetal development encounters a hostile environment. Hyperglycemia in utero may trigger metabolic conditions in the offspring, including abnormalities of glucose tolerance and weight excess. Physicians assisting pregnant women have to be aware about these conditions, because they may go unnoticed if not properly screened. Because an early diagnosis and appropriate management may prevent most of the possible negative consequences for the progeny, the prevention, early diagnosis, and proper management of these endocrine conditions should be offered to all women undergoing pregnancy. Here, we comprehensively review the current evidence about the effects of maternal thyroid dysfunction and maternal dysglycemia on the cognitive function and carbohydrate metabolism in the offspring, two prevalent conditions of utmost importance for the child's health and development. [ABSTRACT FROM AUTHOR]

Oncogenic BRAF and RAS mutations as well as multiple known (and yet unknown) RET fusion oncogenes comprise the majority of causative molecular alterations in papillary thyroid carcinoma (PTC). Apparently "mutation-negative" PTCs encompass a heterogenous group impeding analysis of prognostic significance of underlying genetics. BRAF wild type PTC tissue of 56 patients was analyzed using two established methods: hybrid-specific RT-PCR for the predominant rearrangement RET/PTC1 and fluorescent in situ hybridization (FISH). Clinical features of the cases with and without RET rearrangement were compared (patient age, gender, tumor size, focality, lymph node affection, and iodine avidity). RT-PCR revealed RET/PTC1 rearrangements in five of 56 tumors (9%). FISH confirmed these, and identified four additional RET rearrangements (9/56; 16%). Loss of the iodine avidity only occurred in cases of RET/PTC hybrids (7/9 tumors), but not in RET/PTC-negative PTCs (0/41 tumors with available uptake information; p = 0.029). The risk to develop lymph node metastases was eight times higher in presence of RET rearrangements (p = 0.010). FISH analysis, in contrast to hybrid-specific RT-PCR, revealed infrequent and unknown RET fusion genes. The presence of RET rearrangements was associated with a significantly elevated risk to develop iodine refractory disease and lymph node metastases. Of note, significant clinical discrimination was only achievable when taking the FISH results into account; differences would have been missed when using the RT-PCR method only. Increasing evidence of the clinical impact of RET/PTC-positivity may influence the decision on the extent of surgical resection, especially on lymph node dissection, in PTCs. [ABSTRACT FROM AUTHOR]

Autoimmune and autoinflammatory diseases affect millions worldwide. These classes of disease involve abnormal immune activation of both the innate and adaptive immune systems. While both classes of disease represent a spectrum of aberrant immune activation, excessive activation of the innate immune system has been considered causal for the inflammation and tissue damage found in autoinflammatory diseases, while excessive activation of the adaptive immune system has been thought to primarily contribute to end-organ symptoms noted in autoimmune diseases. Interestingly, the endoplasmic reticulum aminopeptidase 1 (ERAP1) protein, well known for its aminopeptidase function as a "molecular ruler", trimming peptides prior to their loading onto MHC-I molecules for antigen presentation in the ER, has also been shown to be genetically associated with both autoinflammatory and autoimmune diseases. Indeed, this multifaceted protein has been found to have many functions that affect both the innate and adaptive immune responses. In this review, we summarize these findings, with an attempt to identify the possible ERAP1 dependent mechanisms responsible for the pathogenesis of multiple, ERAP1 associated diseases. [ABSTRACT FROM AUTHOR]

Abstract The relationship between iodine intake and clinicopathologic characteristics of papillary thyroid cancer (PTC) is unclear. We aim to investigate the relationship between iodine intake and central lymph node metastasis (CLNM) of PTC. A total of 4040 consecutive patients with PTC receiving thyroidectomy and central lymph node dissection were enrolled from 2013 to 2018. Pathological features of tumors and urinary iodine concentration (UIC) were recorded. Multivariate analysis was performed to investigate the association between iodine intake and CLNM of PTC. More than adequate (UIC: 200.0-299.9 μg/L) and excessive iodine intake (UIC ≥ 300.0 μg/L) were present in 1741 cases (43.09%). Iodine deficiency (UIC ≤ 99.9 μg/L) was inversely associated with female PTC risk only with OR (95% CI): 0.48 (0.29–0.80) relative to adequate iodine intake (UIC: 100.0–199.9 μg/L). However, more than adequate and excessive iodine intake was not associated with PTC risk among the general population and patients with thyroid nodules. In addition, high iodine intake was not associated CLNM risk of PTC. After defining CLNM as metastatic lymph nodes ≥ 2, excessive iodine intake was marginally associated with CLNM among female PTC patients with OR (95% CI): 1.25 (0.99–1.57) by multivariate analysis. Additionally, excessive iodine intake was marginally associated with larger tumor size and capsular invasion. Furthermore, we found that female PTC patients were more closely linked with iodine intake than male ones. In conclusion, high iodine intake appears not to be an initiator, but may be a weak promoter for female PTC progression, which needs further validation. [ABSTRACT FROM AUTHOR]

Background Iodine is an essential micronutrient for intellectual development in children. Information on iodine intakes based on 24-h urinary iodine excretion (UIE) is scant, because iodine status is only assessed by the measurement of urinary iodine concentration (UIC) in spot urine samples. Objectives The aim of our study was to evaluate the iodine intake of school-age children and adolescents, using UIE measurement in 24-h urine collections. Methods The study population included 1270 healthy subjects (677 boys, 593 girls) aged 6–18 y (mean age ± SD: 10.3 ± 2.9) from 10 Italian regions. Daily iodine intake was estimated as UIE/0.92, based on the notion that |$\sim$| 92% of the dietary iodine intake is absorbed. The adequacy of intakes was assessed according to the Dietary Reference Values for iodine of the European Food Safety Authority (EFSA). Body mass index (BMI) and UIC were also measured for each subject. Results Based on the scientific opinion of EFSA, 600 of 1270 subjects (47.2%) had a lower than adequate iodine intake, with a higher prevalence among girls (54.6%) compared with boys (40.2%) (P  < 0.001). Although UIE and 24-h urinary volumes increased with age (P  < 0.001), a progressive decrease in the percentage of subjects with iodine excretion <100 µg/24 h (P  < 0.001) was observed, without any significant difference in the percentage of subjects with UIC <100 µg/L. No significant association was detected between BMI z -score and UIE (P  = 0.603) or UIC (P  = 0.869). Conclusions A sizable proportion of our population, especially girls, appeared to be at risk of iodine inadequacy. The simple measurement of UIC could lead to underestimation of the occurrence of iodine deficiency in younger children, because of the age-related smaller urine volumes producing spuriously higher iodine concentrations. [ABSTRACT FROM AUTHOR]

Abstract Graves' disease (GD) and autoimmune thyroiditis (AT) are the two main clinical presentations of AITD, and their clinical hallmarks are thyrotoxicosis and hypothyroidism, respectively. GD, and AT, can be associated with other organ specific, or systemic autoimmune diseases in the same patient. However discordant results have been reported in the literature about the possible associations. Here, we review the association of GD and other autoimmune syndromes. Furthermore, we report the results of our prospective study that investigated the prevalence of other autoimmune disorders in 3209 GD patients (984 with Graves' ophthalmopathy), with respect to 1069 healthy controls, or 1069 patients with AT, or 1069 with multinodular goiter (matched by age, gender, coming from the same area, with a similar iodine intake). On the whole, 16.7% of GD patients had another associated autoimmune disease; and the most frequently observed were: vitiligo (2.6%), chronic autoimmune gastritis (2.4%), rheumatoid arthritis (1.9%), polymyalgia rheumatica (1.3%), multiple sclerosis (0.3%), celiac disease (1.1%), diabetes (type 1) (0.9%), systemic lupus erythematosus and sarcoidosis (<0.1%), Sjogren disease (0.8%). Moreover, 1.5% patients with GD had three associated autoimmune disorders. Interestingly, patients with Graves' ophthalmopathy (GO) had another autoimmmune disorder more frequently (18.9%), with respect to GD patients without GO (15.6%). However the pattern of the associated autoimmune disorders in GD was not significantly different from that observed in AT patients. In conclusion, we suggest GD patients who are still sick, or who develop new unspecific symptoms (even if during an appropriate treatment of hyperthyroidism) should be appropriately screened for the presence of other autoimmune disorders. Highlights • About 17% of GD patients had another associated autoimmune disease. • The association of 3 autoimmune diseases is present in 1.5% of GD patients. • GO patients had another autoimmmune disorder more frequently vs. GD without GO. • The pattern of associated autoimmune disorders in GD is not different than in AT. • GD developing new unspecific symptoms should be screened for autoimmune disorders. [ABSTRACT FROM AUTHOR]

Objective: Despite high prevalence in a female population, surprisingly little is known about sexual functioning of women with thyroid hyperfunction. This study was aimed at assessing female sexual function and depressive symptoms in women with overt hyperthyroidism of autoimmune and non-autoimmune origin.Study Design: The study included three age-matched groups of young women inhabiting the Upper Silesia (a selenium-deficient and iodine-sufficient area): individuals with overt hyperthyroidism induced by Graves' disease (group A, n = 31), women with overt hyperthyroidism caused by toxic multinodular goiter or toxic adenoma (group B, n = 30) and women with normal thyroid function (group C, n = 34). Apart from measuring serum hormone levels, serum antibody titers and determining calculated parameters of thyroid homeostasis, all women completed questionnaires evaluating femalesexual function (FSFI) and depressive symptoms (BDI-II).Results: The mean total FSFI score and all domain scores were lower while the overall BDI-II score was higher in both groups of women with overt hyperthyroidism than in the control group, and correlated with thyrotropin and free thyroid hormone levels, as well as with the SPINA-GT index. The FSFI score as well as domain scores for desire, arousal and sexual satisfaction were lower, while the BDI-II score was higher in group A than in group B. In group A, the total FSFI score, desire, arousal, sexual satisfaction and severity of depressive symptoms correlated with TRAb and TPOAb titers.Conclusion: The obtained results suggest that excessive thyroid hormone production and thyroid autoimmunity have an additive effect on sexual functioning and mood. [ABSTRACT FROM AUTHOR]

• Biofortification with iodoquinolines significantly increases the iodine content in kale. • Variety of kale has no effect on the amount of accumulated iodine. • Consumption of 50 and 100 g portions of biofortified kale would significantly cover the RDA for iodine. • Consumption of kale enriched with iodoquinolines is safe for consumers (HQ < 1.0). • Application of iodoquinolines do not have a negative effect on kale yields. Iodine is a trace element essential for the proper function of the human body, while quinoline derivatives demonstrate many health-promoting properties. Despite the obligatory iodization of table salt introduced by the World Health Organization, there is still a significant population worldwide at risk of iodine deficiency. Because of the need to reduce the dietary supply of table salt, it is necessary to search for new alternative sources of this mineral. The aim of this study was to determine the effectiveness of kale biofortification with iodoquinolines, to estimate daily iodine intake and to determine the effect of iodoquinolines on the yield as well as the chemical composition of two kale (Brassica oleracea L. var. sabellica) cultivars cv. 'Oldenbor F 1 ' (green kale) and cv. 'Redbor F 1 ' (red kale), cultivated in a hydroponic system. The applied compounds: KIO 3 , 8-Hydroxy-7-iodo-5-quinolinesulfonic acid, 5-Chloro-7-iodo-8-quinolinol and 5,7-diiodo-8-quinolinol, significantly increased iodine concentration in plants without having any effect on yields. Treatment with 8-Hydroxy-7-iodo-5-quinolinesulfonic acid for the iodine biofortification of plants was as effective as the application of KIO 3. In addition, the calculated hazard quotient values indicate that the iodine content of kale was safe for the consumer. The obtained results showed that the chemical composition of kale was more influenced by the cultivar of kale than by the used iodine compound. Kale is a natural source of many bioactive compounds, and the application of iodoquinolines has the potential to further enhance its health-promoting properties. In this study, we present that the treatment with iodoquinolines is a promising new method for biofortification of kale grown in a hydroponic system with iodine. In the future, this novel approach to increasing the iodine content of leafy vegetables could be an important aspect of worldwide iodine prevention. [Display omitted] [ABSTRACT FROM AUTHOR]

To illustrate the changes of iodized salt usage, goiter rate of school-aged children and median urinary iodine concentration (MUIC) of school-aged children in Chongqing for the last 21 years. This study aims to estimate the variational provincial status of iodine nutrition and provide scientific evidence for fine-tuning and adaptation of the current program. Different number of families and school children aged 8–10 years from Chongqing during 1997–2018 participated in the study. UIC and iodine content in table salt were measured. Thyroid volumes of students were examined and goiter prevalence was calculated across years. The median iodine content of table salt was negatively associated with years(r = −0.727, P < 0.01). The MUIC were decreased annually (ranged between 200 and 300 μg/L) and was negatively associated with year(r = −0.831, P < 0.01). Goiter of school-aged children in Chongqing was decreased from the highest rate of 23.58% in 1999 to 1.62% in 2018(Cochran-Armitage Trend Test: χ 2 = -30.695, P < 0.01). Thyroid volume were negatively associated with years(r = −0.962, P < 0.01) and had a positive relationship with MUIC 1997–2018 (r = 0.862, P < 0.01). The consumption of adequately iodized salt can eliminate Iodine deficiency disorders (IDD) in children, but possible excessive iodine intake from salt could result in high urinary iodine excretion and even goiter. A systematic, well-designed and continual program monitoring is essential to ensure the adequacy of iodine fortification levels and to regularly change the iodine concentration in household table salt. [ABSTRACT FROM AUTHOR]

• Drinking milk is acknowledged as one of the main sources of iodine in human diet. • This study assessed energy dispersive X-ray fluorescence for milk iodine prediction. • Trials were performed on liquid milk, without recurring to sample lyophilization. • X-ray technology has mid accuracy in the prediction of milk iodine concentration. Iodine represents a fundamental element for human health, with particular regard to thyroid function. Dietary intake of milk naturally rich in iodine becomes of primary importance in the prevention of syndromes related to iodine deficiency. The concentration of iodine in milk is characterized by wide variability, mainly related to animal feed and level of mineral supplementation. Therefore, there is interest in the development of fast analytical techniques which are able to predict milk iodine concentration. The aim of the present study was to investigate the effectiveness of energy-dispersive X-ray fluorescence (ED-XRF) for the prediction of iodine in cow milk. Results showed moderate accuracy of the ED-XRF technique, with a coefficient of determination in cross validation of 0.60. This study represents a first contribution towards the possibility to discriminate milk with high or low iodine concentration, as an essential preliminary step for the introduction into the market of naturally fortified milk. [ABSTRACT FROM AUTHOR]

Insomnia is known to exacerbate pain symptoms. The purpose of the present study was to compare the secondary effects of cognitive behavioral therapy for insomnia (CBT I) against a novel treatment for insomnia called acceptance and behavioral changes for insomnia (ABC-I) among individuals with comorbid pain. Differences in the potential mechanisms through which these treatments impact pain were also examined. Data consisted of a secondary analysis from a randomized comparative effectiveness trial of CBT-I and ABC-I among women veterans with insomnia and comorbid pain. Pain outcomes, beliefs about sleep, and psychological flexibility were assessed at baseline, post-treatment, and at three-months follow-up. At baseline, 93 women veterans reported comorbid insomnia and pain (mean age = 46.7; 33.3% Black, 24.7% Hispanic/Latina). Both CBT-I (n = 48) and ABC-I (n = 45) were associated with decreased pain intensity (p <.001, Cohen's d = 0.41–0.67) and pain interference (p <.001, Cohen's d = 0.71–0.77) at post-treatment and three-months follow-up, with results indicating that ABC-I was non-inferior to CBT-I for pain improvement. Both conditions were associated with greater psychological flexibility post-treatment, and CBT-I resulted in larger reductions in dysfunctional beliefs about sleep (p =.01, Cohen's d = 0.59). CBT-I and ABC-I both had positive secondary effects on pain with ABC-I being non-inferior to CBT-I with respect to its impact on pain. The mechanisms of change associated with these treatments may differ with CBT-I leading to greater reductions in dysfunctional beliefs. Hybrid treatments which incorporate an acceptance and commitment approach to both insomnia and pain warrant further examination. • Women veterans are prone to both insomnia and pain. • Cognitive behavioral therapy for insomnia (CBT I) can improve pain. • CBT-I was compared to Acceptance and Behavioral Changes for Insomnia (ABC-I). • ABC-I combines behavioral sleep strategies with Acceptance and Commitment Therapy. • ABC-I was non-inferior to CBT-I with respect to its effect on pain outcomes. [ABSTRACT FROM AUTHOR]

Supplementation is an alternative with potential benefits for the prevention of iodine deficiency in pregnancy. To evaluate the effects of iodine supplementation on maternal thyroid hormone concentrations and iodine status during and/or before pregnancy. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The search was conducted in the databases: Cochrane, Embase, Pubmed/MEDLINE and Scopus. Studies involving pregnant women of all trimesters who received oral iodine supplementation were included. Study selection was performed in the Rayyan program. Risk of bias was assessed by the Joanna Briggs Institute tool. Meta-analysis was performed in R software version 4.0.4. Eleven articles with low and moderate risk of bias were included. According to the results of the meta-analysis, supplementation of 200 μg/day of iodine was able to change urinary iodine concentration during pregnancy, thus contributing to adequate intake. When evaluating the period when the intervention started, the best time to start supplementation was prior to pregnancy or in early pregnancy. Daily iodine supplementation had satisfactory effects on iodine status and maternal thyroid hormone concentrations. Although supplementation with 200 µg showed positive effects on iodine status in pregnancy, some studies showed no effect. Prospero Registration: CRD42021249307 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=249307). • In the group supplemented with 200 micrograms the heterogeneity was null. • Iodine supplementation should be started pre-pregnancy or in early pregnancy. • Daily iodine supplementation had beneficial effects on maternal thyroid hormone concentrations. • Iodine supplementation in pregnancy increased Urinary Iodine Concentration values. [ABSTRACT FROM AUTHOR]

• Treatment-resistant depression (TRD) predicts reduced insomnia severity with CBT-I. • Short sleep duration predicts a poor insomnia response to CBT-I for insomnia. • Daytime dysfunction enhances CBT-I efficacy for insomnia. • Seasonal fluctuations of depressive symptoms and sleep significantly enhance CBT-I efficacy. • MDE with suicide attempts predict a poorer improvement of daytime dysfunction. Insomnia plays a critical role in the onset and maintenance of Major Depressive Episode (MDE). Cognitive behavioral therapy for insomnia (CBT-I) can successfully improve the sleep of patients with insomnia and MDE. Nonetheless, the factors influencing CBT-I's effects in MDE remain uncertain. This study aimed to identify predictors of insomnia improvement following CBT-I, as well as predictors of insomnia response, remission in patients with MDE and specific insomnia subtypes. Initially, we compared a 4-session weekly CBT-I treatment to baseline sleep education (SE) in a control group. This confirmed CBT-I's positive effects and the need to explore predictive factors. Notably, treatment-resistant depression (TRD) predicted reduced insomnia severity with CBT-I. Patients exhibiting seasonal fluctuations in depressive symptoms and sleep patterns throughout the year, or having daytime dysfunction, experienced enhanced CBT-I efficacy, especially for early awakenings insomnia. Conversely, shorter sleep duration predicted a less favorable response to CBT-I, less improvement in daytime dysfunction and sleep disturbance worries. Additionally, MDE with suicide attempts predicted a poorer improvement of daytime dysfunction. Further research is essential to comprehensively grasp the mechanisms behind CBT-I's heightened effectiveness in MDE patients with TRD and seasonal fluctuations. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the proposed changes in the eighth edition of the tumor-node-metastasis staging system (TNM-8) compared with the seventh edition (TNM-7) in terms of pathologic subtypes, using a large multicenter thyroid cancer cohort.Materials and Methods: We retrospectively reviewed 7717 patients with papillary (PTC) and 273 with follicular thyroid carcinoma (FTC) who underwent thyroid surgery between 1996 and 2005. We assessed the proportion of variation explained (PVE) to compare the predictive accuracy of disease-specific survival (DSS).Results: During a median 11.3 years of follow-up, 169 (2%) disease-specific deaths were recorded. In patients with PTC, the 10-year DSS rates of stages I, II, III, and IV disease in TNM-8 were 99.6%, 95.7%, 81.5%, and 54.8%, respectively; the corresponding rates in TNM-7 were 99.6%, 98.4%, 98.4%, and 90.1%, respectively. In patients with FTC, the 10-year DSS rates of stages I, II, III, and IV disease in TNM-8 were 97.2%, 69.8%, 50.0%, and 45.5%, respectively; the corresponding rates in TNM-7 were 98.3%, 90.0%, 92.3%, and 42.1%, respectively. Comparing TNM-7 and TNM-8, the PVE values increased from 3.4% to 4.7% in the PTC group, whereas they decreased from 17.5% to 14.5% in the FTC group.Conclusion: Our study suggests that the changes in TNM-8 have improved the clinical usefulness of the TNM staging system in terms of predicting DSS in patients with PTC but not FTC. Further studies to establish a more predictable TNM staging system that focuses on patients with FTC are necessary. [ABSTRACT FROM AUTHOR]

Highlights • Marginal ID during pregnancy and lactation resulted in mild damage to cerebellar BGs morphogenesis in offspring. • The disturbance of Dll1-Notch1 signaling may be involved in the damage to BGs. • Marginal ID also reduced the expression of RBP-Jκ and BLBP. Abstract During early pregnancy, iodine deficiency (ID) is linked to adverse effects on child motor and psychomotor function. Maternal marginal ID has become a common public health problem. It is unclear whether marginal ID influences the development of the cerebellum or its underlying mechanisms. Thus, the purpose of this study was to determine the effects of marginal ID on the development of cerebellar Bergmann glial cells (BGs) and investigate the activation of the Notch signaling pathway, which is crucial for the development and morphology of BGs. We treated Wistar rats with an ID diet (iodine content 60 ± 1.5 ng/g) supplemented with deionized water containing different concentrations of potassium iodide (KI) (183, 117, and 0 μg/L for the control, marginal ID, and severe ID groups, respectively) during pregnancy and lactation. We explored the morphology of the BGs by Golgi-Cox staining and immunofluorescence and investigated the Notch signaling pathway using western blot. Our results showed that the marginal ID and severe ID groups had decreased cerebellar BG fiber lengths (P < 0.05 and 0.01, respectively) and numbers (P < 0.01 for both) on postnatal day (PN) 7, PN14, and PN21 compared to the control group. Moreover, the data showed that severe ID significantly reduced Dll1, Notch1, RBP-Jκ, and BLBP protein levels at all three time points. Marginal ID slightly reduced the expression of Notch1 on PN7 (P < 0.05) and PN21 (P < 0.01), RBP-Jκ on PN14 (P < 0.01) and PN21 (P < 0.05), and BLBP on PN7 (P < 0.05). There was no significant difference in Dll1 protein levels between the marginal ID and control groups at any time point. Our study suggests that marginal ID leads to mild damage to BG morphogenesis in the cerebellum. The abnormal regulation of the Notch signaling pathway may be involved in the damage to BGs. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to evaluate the impact of the revised Chinese National Standard GB26878-2011 'Iodine Content in Edible Salt' on the iodine status among the Chinese population. Methods In 2011 and 2014, the probability proportionate to size sampling (PPS) was used in each Chinese province to obtain the representative data. In each sampling unit, school children aged 8-10 years and pregnant women were selected. Key indicators included urinary iodine concentration (UIC), thyroid volume (TV), and the iodine content in edible household salt. Results The median urinary iodine concentration (MUIC) decreased between 2011 and 2014 from 238.6 to 197.9 µg/L in school-age children. The number of provinces with iodine excess decreased to zero. The proportion of children whose UIC was > 300 µg/L was 18.8% and decreased to 11% compared with 29.8% in 2011. There was no significant difference in UIC < 50 µg/L between 2014 (4.3%) and 2011 (3.7%) (P > 0.05). The MUIC among pregnant women in 2014 was more concentrated between 110 and 230 µg/L. The goiter rate among children aged 8-10 years was unchanged, both the goiter rate of 2011 and 2014 remaining below 5%, in view of the sustainable elimination of iodine deficiency disorders. Conclusion The National Standard GB26878-2011 'Iodine Content in Edible Salt' that was introduced in March 2012 resulted in an overall improvement in iodine status, reducing the risk of excessive iodine intake in the Chinese population. [ABSTRACT FROM AUTHOR]

Contaminated water with chlorates is a public health problem associated with iodine deficiency. Epidemiological evidence shows that iodine deficiency is a risk factor for preeclampsia (PE). In this study we use human BeWo trophoblast cells exposed to perchlorate (KClO 4 ) and changes in gene expression were analyzed by microarrays, quantitative RT-PCR (qRT-PCR) and immunoblot. The microarray analysis identified 48 transcripts up-regulated and 112 down-regulated in comparison with non-exposed trophoblast. The qRT-PCR analysis confirmed changes in GAS7, PKP2, Emilin, Dynatic 3, protocadherins 11, 15, gamma A12, EGFR, SAFB1, ACE2, ANXA2, Apoliprotein E, SREBF1, and C/EBP-β. KClO 4 exposition decreased the mRNA and protein of C/EBP-β and GPX4. Also, we observed a nuclear translocation of HIF1α protein, and increase in both Snail and ACE2 protein by immunoblot. These effects were accompanied by an increases in ROS and nitric oxide. In conclusion, our results show that exposure to KClO 4 alters genes involved in migration, adhesion, differentiation, and correlate with the increase of oxidative stress and nitric oxide production in trophoblast cells. It is possible that iodine deficiency is associated with these processes. However, further studies are required to corroborate the role of iodine in trophoblast cells. [ABSTRACT FROM AUTHOR]